ADJ11599995 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied; applicant takes nothing by way of her workers' compensation claim.

Applicant seeks reconsideration of the WCJ's Findings of Fact of December 22, 2023, which found no industrial injury; the WCJ filed a Report and Recommendation on Petition for Reconsideration, and the WCAB panel denies the petition.

Read the official decision →

This docket was decided more than once. Shown here is the latest released decision; we also hold February 26, 2021.

What was disputed, and how it came out

Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.

AOE/COEDefendant prevailedshoulder · back · knees · ankles · feet · hands

The WCJ found no industrial injury and that the Labor Code section 5402(b) presumption was not applicable; the WCJ's findings were adopted by the WCAB panel, which denied reconsideration.

From the decision · page 1Applicant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings of Fact of December 22, 2023, wherein it was found that while employed as a maintenance worker during a cumulative period ending on June 11 2018, applicant did not sustain industrial injury to her shoulder, back, knees, ankles, feet, and hands. The WCJ thus issued an order that applicant take nothing by way of her workers' compensation claim.1

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The WCJ found no substantial medical evidence of industrial injury to the shoulder, back, knees, ankles, feet, and hands during the cumulative period ending June 11, 2018.

Favours Defendant prevailed

This finding was the basis for denying the applicant's claim and the petition for reconsideration.

From the decision · page 1Applicant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings of Fact of December 22, 2023, wherein it was found that while employed as a maintenance worker during a cumulative period ending on June 11 2018, applicant did not sustain industrial injury to her shoulder, back, knees, ankles, feet, and hands. The WCJ thus issued an order that applicant take nothing by way of her workers' compensation claim.1

Dr. Andrade's QME report was relied upon as substantial evidence on causation and AOE/COE issues.

Favours Defendant prevailed

The WCJ and panel found Dr. Andrade's report the most accurate and factually supported medical evidence.

From the decision · page 4Dr. Andrade, the QME, did not find any arthritic disability and felt her complaints should have dissipated if she had not worked in over three months. She had advised the QME that her work was not overly strenuous.

Dr. Espinosa's personal medical records did not support work-related causation and indicated the calcaneal spur was unrelated to work.

Favours Defendant prevailed

The WCJ relied on these records to reject the claim of industrial injury.

From the decision · page 4As I read the medicals, it became clear that the applicant did not understand what she described as "the bone out of place in her foot", a calcaneal spur that is simply a calcium deposit of no clear medical etiology and often possibly related to obesity and diabetes. The first person to diagnose this calcium deposit was

The chiropractors' reports co-signed by Dr. Russman provided no causation information and were rejected as not helpful or insightful.

Favours Defendant prevailed

This lack of causation evidence contributed to the denial of the claim.

From the decision · page 5In this Petition for Reconsideration applicant's counsel complains that I didn't rely on any of the reporting's of the multiple chiropractors reporting cosigning with Dr. Russman. Quite frankly, they provide no information beyond range of motion. Nothing in these early reports establishes in the facts of causation. Nothing explains the gap in reporting or why she left work in the first place.

What the panel did with the medical opinions

The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.

QMERelied upon

Did not find any arthritic disability and felt complaints should have dissipated if not working over three months; reporting was the best evidence on AOE/COE and causation issues.

The WCJ relied on Dr. Andrade's report as substantial medical evidence on causation and AOE/COE issues.

From the decision · page 4Dr. Andrade, the QME, did not find any arthritic disability and felt her complaints should have dissipated if she had not worked in over three months. She had advised the QME that her work was not overly strenuous.

PTPRelied upon

Diagnosed calcaneal spur unrelated to work; did not indicate work causation; provided options for relief but did not push surgery.

The WCJ found Dr. Espinosa's records did not support work-related causation and relied on them in denying injury.

From the decision · page 4As I read the medicals, it became clear that the applicant did not understand what she described as "the bone out of place in her foot", a calcaneal spur that is simply a calcium deposit of no clear medical etiology and often possibly related to obesity and diabetes. The first person to diagnose this calcium deposit was

otherRejected

Reports provided no causation information beyond range of motion; did not review diagnostics; no firm link to causation found.

The WCJ rejected the chiropractors' reports co-signed by Dr. Russman as not helpful or insightful on causation.

From the decision · page 5In this Petition for Reconsideration applicant's counsel complains that I didn't rely on any of the reporting's of the multiple chiropractors reporting cosigning with Dr. Russman. Quite frankly, they provide no information beyond range of motion. Nothing in these early reports establishes in the facts of causation. Nothing explains the gap in reporting or why she left work in the first place.

ADJ11599995 · March 4, 2024

What the panel ordered

What was disputed, and how it came out

Your case already resembles someone else’s. Find whose.

The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

About this page